Filgotinib Radiographic and Clinical Efficacy Versus Other JAK Inhibitors and Adalimumab in Patients With Rheumatoid Arthritis and Inadequate Response to Methotrexate: A Systematic Review and Network Meta-Analysis.

IF 2.9 3区医学 Q2 RHEUMATOLOGY

Rheumatology and Therapy Pub Date : 2025-06-01 Epub Date: 2025-04-10 DOI:10.1007/s40744-025-00757-7

Yoshiya Tanaka, Rene Westhovens, Hong Sun, Carole Van der Donckt, Yan Zhong, Toshihiko Kaise

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引用次数: 0

Abstract

A Bayesian network meta-analysis was conducted to examine the radiographic and clinical efficacy of the Janus kinase (JAK) inhibitors tofacitinib, baricitinib, upadacitinib, and filgotinib and the biologic disease-modifying antirheumatic drug (bDMARD) adalimumab (all given with methotrexate [MTX]) in patients with rheumatoid arthritis (RA) and an inadequate response to MTX (MTX-IR). The PubMed database was systematically searched to identify relevant randomized controlled trials. Efficacy outcomes included the modified total Sharp score (mTSS), erosion, joint space narrowing, 70% improvement in American College of Rheumatology criteria (ACR70), Boolean remission, Clinical Disease Activity Index (CDAI) score ≤ 2.8, and Simplified Disease Activity Index (SDAI) score ≤ 3.3. Five studies were identified using the inclusion criteria, and two additional publications presented further results from one of the five studies, with the total meta-analysis population comprising 6933 patients. Among all JAK inhibitors analyzed and the bDMARD adalimumab, filgotinib 200 mg had the highest probability of being the treatment with the greatest improvement in mTSS versus placebo at 48/52 weeks, followed by filgotinib 100 mg, adalimumab 40 mg, baricitinib 4 mg, and upadacitinib 15 mg. Filgotinib 200 mg also had the highest probability of being the treatment with the greatest improvement in erosion and joint space narrowing at 48/52 weeks versus the same comparators. At 12 weeks, filgotinib 200 mg had the highest probability versus other JAK inhibitors and adalimumab of achieving clinical remission (CDAI ≤ 2.8 and SDAI ≤ 3.3). Varying treatments had the highest probability of achieving other efficacy outcomes of interest at 12, 24/26, and 48/52 weeks. In the absence of head-to-head comparisons, this analysis provides valuable evidence for the role of filgotinib in the treatment of patients with MTX-IR RA.

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非戈替尼与其他JAK抑制剂和阿达木单抗在类风湿关节炎和甲氨蝶呤反应不足患者中的放射学和临床疗效：系统评价和网络荟萃分析

一项贝叶斯网络荟萃分析研究了Janus激酶（JAK）抑制剂tofacitinib、baricitinib、upadacitinib和filgotinib以及生物疾病改善抗风湿药物（bDMARD）阿达木单抗（均与甲氨蝶呤[MTX]一起给予）在类风湿关节炎（RA）和MTX反应不充分（MTX- ir）患者中的放射学和临床疗效。系统地检索PubMed数据库以确定相关的随机对照试验。疗效指标包括改良总夏普评分（mTSS）、糜烂、关节间隙变窄、美国风湿病学会标准（ACR70）改善70%、布尔缓解、临床疾病活动指数（CDAI）评分≤2.8、简化疾病活动指数（SDAI）评分≤3.3。使用纳入标准确定了五项研究，另外两篇出版物提供了五项研究之一的进一步结果，总meta分析人群包括6933名患者。在分析的所有JAK抑制剂和bDMARD阿达木单抗中，与安慰剂相比，在48/52周时，非戈替尼200 mg最有可能成为mTSS改善最大的治疗方案，其次是非戈替尼100 mg、阿达木单抗40 mg、巴西替尼4 mg和upadacitinib 15 mg。与相同的比较物相比，非哥替尼200mg在48/52周时对糜烂和关节间隙狭窄有最大改善的可能性也最高。在12周时，非戈替尼200mg与其他JAK抑制剂和阿达木单抗相比，获得临床缓解的可能性最高（CDAI≤2.8和SDAI≤3.3）。不同的治疗方法在12周、24/26周和48/52周获得其他感兴趣的疗效结果的可能性最高。在没有正面比较的情况下，该分析为非戈替尼在治疗MTX-IR RA患者中的作用提供了有价值的证据。

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来源期刊

Rheumatology and Therapy RHEUMATOLOGY-

CiteScore

6.00

自引率

5.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Rheumatology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of rheumatologic therapies. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. Areas of focus include, but are not limited to, rheumatoid arthritis, gout, gouty arthritis, psoriatic arthritis, osteoarthritis, juvenile idiopathic/rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis, Pompe’s disease, inflammatory joint conditions, musculoskeletal conditions, systemic sclerosis, and fibromyalgia. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial protocols, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Rheumatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Ethics and Disclosures The journal is a member of the Committee on Publication Ethics (COPE) and subscribes to its principles on how to deal with acts of misconduct thereby committing to investigate allegations of misconduct in order to ensure the integrity of research. Content in this journal is peer-reviewed (Single-blind). For more information on our publishing ethics policies, please see here: https://www.springer.com/gp/editorial-policies Rapid Publication The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid and efficient communication of the latest research and reviews, allowing the advancement of rheumatologic therapies. 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